Acute

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Acute Respiratory Infection
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CONTENT

• I. INTRODUCTION
• Classification
• Global Situation
• Regional Situation
• Current Technology and Approach
• II. DISCUSSION
• Where are we now?
• What are the issues and controversies?
• What could be done?
• III. RECOMMENDATION AND CONCLUSION

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I. INTRODUCTION
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• The most common causes
• Haemophilus Influenzae
• Streptococcus Pneumonia

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• ARI responsible for
• 19 Total Death of Under 5 Babies
• 8.2 the worlds Total Burden of Disability
  and
• Premature Death.
• But only received
• 0.15 of R D budget for
  health
• or only US0.51 per Daly
• Compared to
• HIV US 85 per Daly
• Asthma US 13 per Daly
• Rheumatic Disease US 10 per Daly
• Diarrhoeal Disease US 0.32 per daly

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Very Expensive Rapid increase in
Resistancy US 8 Billion wasted every year
75 Anti Biotic are prescribed, Many are
unnecessary
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CASE MANAGEMENT

• Not able to drink
• Convulsions
• Abnormally sleepy
• or difficult to
• wake
• Stridor in calm
• child
• Severe malnutrition

SIGN
SIGNS
SIGNS

• Chest indrawing
• If also recurrent
• wheezing, go directly
• to Treat wheezing

VERY SEVERE DISEASE
SEVERE PNEUMONIA
CLASSIFY AS
CLASSIFY AS

• Refer urgently to Hosp.
• Give first dose of AB
• Treat fever, if present
• Treat wheezing, if
• present.
• (if referral is not feasible,
• treat with AB and follow)

• Refer urgently to Hosp.
• Give first dose of A.B
• Treat wheezing, if
• present
• If cerebral malaria is
• possible, give an anti
• malarial

TREAT MENT
TREAT MENT
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CASE MANAGEMENT

• No chest indrawing
• and fast breathing
• (50/minute or more if
• child 2 mo.up to 12 mo.
• 40/minutes or more
• if child 12 mo. Up to
• 5 years)

SIGN

• No chest indrawing
• No fast breathing
• (less 50/minute if child
• 2 mo.up to 12 mo. less
• 40/minutes if child
• 12 mo. Up to 5 years)

SIGNS
SIGNS

PNEUMONIA
No Pneumonia
CLASSIFY AS
CLASSIFY AS

• Advise mother to give
• home care
• Give an AB
• Treat fever if present
• Treat wheezing if
• present
• Advise mother to return
• in two days/earlier

• If coughing more than
• 30 days refer
• Assess and treat ear
• problem sore throat
• Assess and treat other
• problems
• Give home care

TREAT MENT
TREAT MENT
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II. DISCUSSION
Fact that ARI, Diarrhea, Measles, Malaria
and malnutrition are the major causes of
death of Under 5 year old children
I.M.C.I.
Fact that there are overlapping in signs
and symptoms, so Focusing to only the
most apparent problem will lead to
Potentially Life Threatening condition be
overlooked.
Fact that treating may be complicated by
the need to combine therapy.
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IMMUNIZATION
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WHOS STANDARD TREATMENT
But Front line health worker? Pediatrician? Commu
nity health worker? Mother?
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DRUG RESISTANCE
Reduce Pneumonia Mortality by 55, all causes by
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But wide spread use, give trend to
Antibiotic Resistance.
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HEALTH CARE SEEKING BEHAVIOUR

• PERCEPTION OF ILLNESS
• UNQUALIFIED DOCTOR
• AND HEALTH WORKER

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CONCLUSION